Abstract
Penetrating torso trauma, often complicated by non-compressible torso hemorrhage (NCTH), is a leading cause of preventable death. Damage control surgery (DCS) is standard care, with resuscitative endovascular balloon occlusion of the aorta (REBOA) emerging as a minimally invasive adjunct for temporary hemorrhage control. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review included six studies with a total of 2,705 patients, comparing combined DCS and REBOA with DCS alone or alternative strategies. Several studies indicated improved survival and faster hemorrhage control, while others reported higher control rates compared to resuscitative thoracotomy. Conversely, some data suggested increased mortality and complications in penetrating abdominal vascular injuries. Pooled findings suggested a potential survival benefit, but heterogeneity and confounding limited certainty. Reported risks included ischemia-reperfusion injury, limb ischemia, and increased transfusion requirements. REBOA may improve outcomes in selected patients, but its benefit appears context-dependent, warranting prospective trials to refine indications and timing.